Call for population health checks in pharmacies

Pilot programme focused on stroke risk factors

Dec 13, 2018

Deborah Condon

Some 27% of people who took part in a pilot programme by pharmacists were found to have high blood pressure, while over 5% were found to have atrial fibrillation (AF) - both major risk factors for stroke.

The Irish Pharmacy Union (IPU) is calling for a national roll-out of population health checks for high blood pressure and AF in community pharmacies. It has just launched a report, which provides details of a pilot programme it ran to detect these conditions in the community.

Over 1,100 people were checked in 68 community pharmacies over a two-month period during the summer of 2018. Among these, 27% were found to have high blood pressure, 5.5% were found to have AF, while 2% showed signs of both conditions.

Some 26% of all those checked were referred to their GP, while 4% were started on medications to treat the conditions.

"These findings are particularly important, especially when Irish data suggests that 64% of people over the age of 50 have high blood pressure and that nearly half of those are undiagnosed. Regarding AF, research suggests an overall Irish prevalence estimate of 3% in the over-50s," commented IPU president, Daragh Connolly.

High blood pressure remains the biggest risk factor for stroke, however it is often seen as a silent risk factor because there may be few physical symptoms. The best way to find out if you have it is to have your blood pressure checked by a doctor, nurse or pharmacist.

AF is also a major risk factor for stroke. It causes irregular and rapid heartbeats, which can make the heart less efficient at pumping blood around the body. While symptoms can include palpitations, breathlessness, dizziness and angina, like high blood pressure, there may be no symptoms, therefore a person may be unaware that they have it.

It can be detected by a simple pulse check.

"High blood pressure is a leading cause of stroke and heart attack which affects almost one million people in Ireland. AF is the most common type of irregular heartbeat, with one in four people over the age of 50 at risk of developing it. People with untreated AF are five times more likely to have a stroke," explained Dr Angie Brown, medical director of the Irish Heart Foundation (IHF), which supported this pilot programme.

Around 8,000 people are hospitalised because of a stroke in Ireland every year, while 1,800 die as a result. An estimated 30,000 people are currently living with a stroke-related disability.

The pilot was seen as highly beneficial by both participants and pharmacists, and it was easy to implement within pharmacies. Some 83% of participants were happy with the information they were given, while 91% said they were made more aware of high blood pressure and AF as a result of taking part.

Some 98% of the participants said they would recommend this health check to a friend, while 99% said they were happy to have taken part.

"The pilot demonstrated that by carrying out a standardised population health check in the community pharmacy, which is a highly accessible healthcare location, pharmacists can deliver an extremely positive benefit to participants in terms of prevention, detection and initial management of suspected high blood pressure and AF," Mr Connolly said.

He added that these findings ‘strongly support the roll-out nationally of a HSE-funded cardiovascular health check service'.